| Doctor Name: | MRS. THERESA ANN CAMPBELL |
| NPI Number: | 1629102025 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN,BC,FNP |
| License Number: | RN069859 |
| Business Practice Address: | 420 West Front Street Slater, MO - 653491328 |
| Business Phone Number: | 6605292251 |
| Business Fax Number: | 6608313328 |
| Mailing Address: | 420 West Front Street, SLATER |
| State: | MO |
| Postal Code: | 653491328 |
| Phone Number: | 6605292251 |
| Fax Number: | 6608313348 |
| NPI Enumeration Date: | 03/15/2007 |
| NPI Last Update Date: | 01/13/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | RN069859 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |